Australian GPs caution against ‘reinventing the wheel’ in Royal Commission response

Key points:

• The Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability’s Final Report was publicly released on September 29, 2023, coming in at 12 volumes with a total of 222 recommendations

• The Final Report identified a need for ‘disability health navigators’ to assist people with cognitive disability and complex health issues to find their way through the health system

• The Royal Australian College of General Practitioners cautioned against ‘reinventing the wheel’ rather than directing funding towards GPs who may be critical in the disability support process

The Royal Australian College of General Practitioners, a peak advocacy body for Australia’s health system, has provided the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability with a submission to address the health care for and knowledge of people living with disability.

In response to the government’s recommendation to create and fund specialist health systems, in addition to ‘health navigators’ for people with cognitive disability, RACGP President Dr Nicole Higgins said it makes more sense to support existing health services including GPs. 

“While the RACGP largely supports the government’s recommendations, it is concerning that the recommendation to establish specialist services doesn’t mention GPs at all — this is a big oversight,” she said. 

“GPs play an integral role in disability care. We support patients from the day they’re diagnosed and are the central point for managing their care, working with other health professionals, their family and carers.

“GPs can make NDIS planning more efficient, reduce duplication and better target supports because they know their patient and what works for them.”

The RACGP recommended increasing patients’ Medicare rebates to reflect the real cost of practitioners providing comprehensive care to patients with disability.

“As it stands, patients’ Medicare rebates don’t cover the true cost of providing comprehensive care to people with disability, and GPs are often left out-of-pocket for things, like completing NDIS paperwork if the patient isn’t present,” Dr Higgins added.

The 11-page submission stated that without funding and incorporating the efforts of GPs, Australia’s disability support system would be at ‘[…] risk of fragmentation of care if this model is not continued and supported.’

“Rather than funding the establishment of new services for people living with cognitive disability, the smartest and most cost-effective investment would be to fund multi-disciplinary care teams with GPs,” she said.

“We shouldn’t reinvent the wheel, it’s costly and causes fragmentation of care which isn’t good for a patients’ health.

“The Royal Commission made it clear that more needs to be done to improve the health and wellbeing of people with disability. We need to get this right. Comprehensive care delivered by GP coordinated teams that are properly funded will improve quality of life for people with cognitive disability and be a much more cost-effective use of limited resources.”

In Australia, people between the ages of five – 64 years with disability who need health care assistance receive only informal assistance.

An Australian Institute of Health and Welfare analysis of self-reported information from the Australian Bureau of Statistics National Health Survey found that people with disability aged under 65 have higher rates of use of:

• GPs — 93 percent compared with 82 percent of those without disability;
• medical specialists — 58 percent compared with 26 percent;
• hospital emergency departments — 20 percent compared with 10 percent.

The RAGCP also welcomed new data showing a 2.1 percent increase in bulk billing for vulnerable patients nationally as evidence that boosting patients’ Medicare subsidies gets results.

“We called last year’s Budget a game-changer because it was the biggest investment in general practice care in decades and funding gets results,” she said. 

“Now we have the data to show it — a 2.1 percent increase in bulk billing nationally since the government’s tripling of bulk billing incentives for healthcare card holders, pensioners and children went live in November and bigger increases in some places, including 5.7 percent in Tasmania and more than four percent in regional Queensland.

“Some of the highest increases are in regional areas, which reflects the higher bulk billing incentives for vulnerable patients in regional Australia. 

“The RACGP called for the tripling of the bulk billing incentives to provide urgently needed relief to the most at-risk people in Australia, who are being squeezed from all sides with the cost-of-living crisis. 

“Last year’s Budget was the first step to strengthen Medicare. There is still a long way to go to repair the decades of cuts and neglect.”

What do you think about the role GPs play in disability support? Are more networks needed or do GPs require more support in the upcoming Federal Budget? Let the team at Talking Disability know and subscribe to the newsletter for more information, news and industry updates.

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